English
CLIENT INFORMATION FOR INFORMED CONSENT: THE DIAPHRAGM
Before using a diaphragm, you need to know the advantages, disadvantages, risks, and warning signs to watch for.
This fact sheet, along with the individualized education provided by our staff represents your informed consent for this
method. You will also be given the FDA approved manufacturer’s information. You are encouraged to read this
information. A Nurse Practitioner is always available to answer any questions you may have.
The diaphragm is a dome-shaped rubber cup with a spring at the rim. A diaphragm is inserted deep into the vagina so
that it covers the cervix to prevent sperm from reaching and fertilizing an egg. It is always used with a spermicidal
cream or jelly. A fitting and prescription is required.
BENEFITS:
 Dual protection: diaphragms offer the benefit of reducing the risk of pregnancy, transmission of some STIs, pelvic
inflammatory disease, and cervical cancer;
 Pregnancy prevention: when used correctly (with every act of intercourse) diaphragms have a 6 percent failure rate.
With typical use (which is inconsistent use), diaphragms have a 20 percent failure rate;
 No serious side effects are associated with proper diaphragm use;
 The diaphragm can be put in place up to six hours before intercourse;
 No systemic side effects;
 They do not alter a woman’s hormonal patterns;
 Lowers risk for cervical dysplasia and cancer.
RISKS:
Talk to your Nurse Practitioner if you have:
· Allergy to spermicide, rubber, latex, or polyurethane;
· Repeated urinary tract infections;
· History of toxic shock syndrome;
· Abnormalities in vaginal anatomy.
These conditions need to be considered when determining if the diaphragm is right for you.
Possible Serious Side Effects:
The most serious side effect of the diaphragm is toxic shock syndrome (TSS). This is a rare but serious disorder caused
from a toxin released by bacteria. Although the chances of serious side effects are very low, it is important to be aware
of the warning signs. Signs and symptoms of TSS can include:
· High fever;
· Seizures;
· Low blood pressure;
· Redness of the eyes, mouth, and throat;
· Confusion;
· A rash that resembles a sunburn on your palms and
· Muscle aches;
soles of your feet.
· Headaches;
Possible Minor Side Effects:
· Irritation or itching of the vagina or penis can usually be taken care of by changing the brand of contraceptive cream or
jelly;
· Pain or trouble urinating after putting in the diaphragm may be caused by incorrect insertion or the diaphragm not
being the right size. If pain continues, see your Nurse Practitioner;
· The diaphragm should not be left in for more than 24 hours. If left in too long, an infection or discharge from the
vagina may develop. If this happens, see your Nurse Practitioner.
In case of a medical emergency, call 911
6/2016
1201 Caledonia Street, La Crosse, WI 54603 | essentialclinic.org
Clinic: (608) 775-8390 or (800) 657-5177 | US DHHS, OPA, OFP
Title X Region V Family Planning Program | In collaboration with Gundersen Health System
CIIC – The Diaphragm #390
English
CLIENT INFORMATION FOR INFORMED CONSENT: THE DIAPHRAGM
HOW TO USE A DIAPHRAGM:
Use your diaphragm with each act of sexual activity; be sure the diaphragm is in place before your partner’s penis enters
the vagina; it can be inserted up to six hours before intercourse;
To Insert
1. Wash your hands with soap and water before handling and inserting the diaphragm;
2. Hold it up to the light to check for holes, cracks, or tears;
3. Apply approximately one teaspoon of spermicidal cream or jelly in the dome of the diaphragm. With the a finger
spread a little cream or jelly on the rim of the diaphragm.
4. Squeeze the sides of the rim together, so the diaphragm folds, and hold it together with two fingers of one hand;
use the other hand to spread the opening of your vagina.
5. Insert the folded diaphragm into your vaginal canal. Push the diaphragm back and downwards as far as it will go.
Check placement with a finger. When correctly placed, the back rim of the diaphragm should be behind the
cervix and the front rim tucked up behind the pubic bone. The cervix should be covered by the dome of the
diaphragm.
If you have intercourse more than once in the six hour time, insert an application of cream or jelly into your vagina each
time. Do not remove the diaphragm.
To remove
1. Leave the diaphragm in for at least six hours after intercourse; the diaphragm should be removed and washed at
least once every 24 hours.
2. When ready to remove, wash your hands with soap and water.
3. Locate the rim of the diaphragm and hook it with your finger. Pull it out and down.
4. Wash the diaphragm with plain soap and water and dry it.
5. Hold it up to the light to check for holes, tears, and cracks.
Taking Care of Your Diaphragm:
· Store your diaphragm in a convenient, cool, and dark location;
· Wash your spermicidal inserter and diaphragm after each use;
· Plain soap is best. Avoid perfumed soap. Avoid talcum powder. Never boil you diaphragm.
· Contact with oil-based products (i.e., Vaseline) can deteriorate your diaphragm. Water-based lubricants are okay (i.e.,
K-Y Jelly or Astroglide);
· The concentration of spermicide in a diaphragm cream or jelly can vary from 1 percent - 5 percent. Use one that is 2
percent or higher. Check the expiration date on the cream or jelly regularly.
You should have your diaphragm fitting checked:
· At your annual check-up;
· If you lose or gain more than 10 pounds;
· If you have a pregnancy;
· If you have any kind of pelvic surgery;
· If the diaphragm causes you pain or discomfort;
· If you have repeated bladder infections.
In case of a medical emergency, call 911
6/2016
1201 Caledonia Street, La Crosse, WI 54603 | essentialclinic.org
Clinic: (608) 775-8390 or (800) 657-5177 | US DHHS, OPA, OFP
Title X Region V Family Planning Program | In collaboration with Gundersen Health System
CIIC – The Diaphragm #390